A Wisconsin federal court ruled in favor of Hartford finding that it was not unreasonable when it denied long term disability benefits to a man with multiple sclerosis (“MS”). Hartford reasoned that while Artz’s MS diagnosis did prevent him from working as a Senior Electric Distribution Controller for his employer, his condition did not prevent him from working in the same position at other companies. Because the disability insurance policy insured Artz’s occupation as it is performed in the national economy and not specifically with his employer, he did not qualify for disability benefits.
Artz’s Disability
Artz had been employed as a Controller at WEC Energy Group (“WEC”), working rotating 12-hour shifts, since 1988. Although he was diagnosed with MS in 2003, Artz continued in his position at WEC for 16 more years in part because the job was mostly sedentary. When his fatigue worsened and his doctors determined his MS was relapsing, he filed a disability claim with Hartford. As part of his claim, Artz’s doctors provided statements concluding that he could only work 8 hours a day, and only during a day (and not night) shift. When Hartford reached out to WEC asking if it could accommodate Artz, WEC responded that it could not.
Hartford’s Plan Language
According to Hartford’s disability insurance contract issued to WEC, a person is disabled if they are unable to perform the Essential Duties of his or her occupation for a significant period time. The language clearly states that the definition of occupation is as it is recognized in the general workplace, and not the specific job being performed for a specific employer at a specific location. Moreover, the ability to work the number of hours in a regularly scheduled work week is considered an “essential duty” under the contract language.
This case demonstrates how complex these disability cases can be. It is not as simple as you cannot do your job for your employer and thus you will get paid disability insurance benefits. The definition of disability and policy requirements are far more complicated and difficult to navigate.
Disability Insurance Companies Have Lawyers. Shouldn’t You?
Because this law firm was created to focus on disability insurance, we have developed an expertise in this complex area of the law.
Our expertise in long-term disability claims means our clients have the backing of a law firm that has attorneys who:
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All our lawyers commit every day of their legal career to helping people get disability benefits from UNUM, MetLife, Prudential, Northwestern Mutual, Hartford, CIGNA, and others.
Because federal law applies to most disability insurance claims, we do not have to be located in your state to help. We help clients nationwide.
Call to get experienced disability lawyers on your side with:
- Submitting a disability insurance claim;
- Appealing a long-term disability denial;
- Negotiating a lump-sum settlement; and/or
- Filing a lawsuit against your disability insurance company.
Call (800) 969-0488 to schedule your free consultation with a disability attorney.
